Recent studies have highlighted deteriorating conditions for cancer patients from the Gaza Strip, who have increasingly been unable to get the treatment needed, putting lives at risk.

The World Health Organisation (WHO) published a comprehensive report at the end of October examining both availability of and access to health services for Palestinians in the West Bank and Gaza.

According to the report, there has been a noticeable increase in denials and delays in responding to permit applications for Gaza patients seeking to exit the Strip via the Erez crossing with Israel in the past two years, in conjunction with the tightening of security procedures.

Gaza has been under an Israeli-imposed blockade for a decade, which has severely restricted travel in and out of the Strip, and well as the entry of goods. The latter has contributed to hindering the development of proper health infrastructure, which is why Gazans in need of specialist treatment are referred, through cumbersome procedures, to hospitals outside the Strip - mostly in East Jerusalem or Israel, with fewer referred to West Bank or Jordanian facilities.

In absolute numbers, 1,780 patients from Gaza were denied permits over a two-year period in 2014-15. One in five patients was called in for a security interview as a condition to travel, while more than half were not notified the reason for the denial or their permit (with 12 percent notified they were denied on security grounds). According to the WHO, “the majority of denials of patients appears to be arbitrary and without relation to any security threats.”

The WHO adds that even with valid permits, patients as well as family members who accompany them risk arbitrary detention and interrogation at the Erez checkpoint, the only civilian crossing between Israel and Gaza. “Some individuals report being pressured to give information about others during security interviews and interrogations,” according to the report.

In addition, Egypt has imposed its own blockade on the Strip since Sisi took power in 2013. As a result, the Rafah crossing between Gaza and Egypt has only been opening a few days a year, although recent diplomatic developments on the regional scene have seen it open more often in the past few weeks.

As Israeli rights group B’Tselem points out, WHO figures for January through October 2016 show that only 1,032 medical patients travelled through Rafah in this period, out of 20,000 who applied.

In the same period, B’Tselem says, more than a quarter (28.09%) of requests from Gaza patients for permits to access cancer treatment in the West Bank or Israel were either denied or ignored – 2,042 in total.

Breast cancer is the most common cancer among Palestinian women, but as few as two in five may live past five years after being diagnosed, according to NGO Medical Aid for Palestinians (MAP). In comparison, four out of five survive in the UK. One of the issues is that radiotherapy is not available in Gaza, and delays in obtaining permits can lead to interrupted care. In addition, chemotherapy medications are often out of stock and diagnosis tends to be late, while doctors face travel restrictions when seeking to update and specialise their skills.